预先镇痛对全子宫切除术后全麻恢复期病人意识恢复的影响  

Effect of preemptive analgesia on recovering depth of patient`s a wareness after complete hysterectomy under general anesthesia

作　　者：张毅[1] 刘凌云[1] 张咸伟[1] 田玉科[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院麻醉学教研室

出　　处：《中国妇幼保健》2005年第24期3312-3314,共3页Maternal and Child Health Care of China

摘　　要：目的:观察预先镇痛是否影响术后病人意识恢复。方法:选择40例ASAI～Ⅲ级行全子宫切除术的病人,随机分为对照组(n=20)和预先镇痛组(n=20),所有病人均在静-吸复合麻醉下完成手术。预先镇痛组在手术开始前使用曲马多1.5mg/kg。两组术后入苏醒室,记录OAA/S镇静评分、VAS镇痛评分、BIS和术后寒颤和躁动的发生率。结果:①VAS,预先镇痛组优于对照组(P<0.05);②OAA/S评分和BIS,在5min和10min两个时间点,预先镇痛组低于对照组(P<0.05);③术后寒颤和躁动的发生率,预先镇痛组明显低于对照组。结论:预先镇痛能够使患者的意识恢复程度有一定程度的延长,但不会造成苏醒延迟。Objective. To observe whether preemptive analgesia affect recovering degree of awareness in postoperative patients. Methods： Forty patients for complete hysterectomy were randomly divided into control group （n = 20 ） and preemptive analgesia group （ n = 20） . All patients had received the operations under general anesthesia. Before operation, patients in the preemptive analgesia group were given tramadol 1. 5 mg/kg intravenously. After operation, all patients were transported into recovering room. OAA/S sedation Score, VAS, bispectral （BIS） and ratio of postoperative shaking chill and harass were recorded. Results： ①VAS： preemptive analgesia group was much better than control group （ P 〈 0. 05 ） ; ②OAA/S and BIS were significantly lower in preemptive analgesia group than that of control group at 5 and 10 min after extubation; ③The ratio of postoperative shaking chill and harass were also significantly lower in preemptive analgesia group than that in control group. Condusion： Preemptive analgesia, to some extent, affects the awareness after general anesthesia, but it can＇t cause awareness delay.

关 键 词：预先镇痛 全子宫切除术 意识恢复程度 全麻恢复期 

分 类 号：R713[医药卫生—妇产科学] R614[医药卫生—临床医学]